Hypoglycaemia

Question 1

What is the definition of hypoglycaemia?

Answer 1

Blood glucose of less than 4.0mmol/L

Question 2

In patients will mild hypoglycaemia i.e. conscious, orientated and able to swallow - what is the management?

Answer 2

Give 15-20g of quick acting carbohydrate, such as 5-7 Dextrosol® tablets or 4-5 Glucotabs

Then test glucose level after 15 mins

Question 3

In patients with moderate hypo, i.e. patient conscious and able to swallow, but confused, disorientated or aggressive

Answer 3

1.5-2 tubes of 40% glucose gel (squeezed into mouth between teeth and gums). If ineffective, use 1mg glucagon IM

Question 4

How long does glucagon take to work?

Answer 4

UP TO 15 MINUTES TO WORK

MAY BE INEFFECTIVE IN UNDERNOURISHED PATIENTS, IN SEVERE LIVER DISEASE AND IN REPEATED HYPOGLYCAEMIA CAUTION IN ORAL HYPOGLYCAEMIC AGENT- INDUCED HYPOGLYCAEMIA.

Question 5

Management of a patient with severe hypoglycaemia i.e. unconscious, seizures, aggressive or nil by mouth

Answer 5

Give IV glucose over 15 minutes as 75ml 20% glucose or
150ml 10% glucose or
1mg Glucagon IM

Question 6

What should be done if a patient has received IM glucagon?

Answer 6

40g long acting carbohydrate e.g. 2 biscuits/slice of bread/200-300ml milk